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Harm reduction programmes to improve the health and rights of People Who Use Drugs (PWUD) show similarities all over the world. In countries where PWUD lack access of quality harm reduction services; are being criminalised; and human rights are being violated, Mainline works hard to promote health and rights to the often ostracised and hidden populations.
Outreach work forms an essential foundation for all harm reduction interventions and is the backbone of an organisation.
Through outreach workers – or low threshold locations – several services are delivered to those who need them, people are educated on safe drug use and, if necessary, are referred to health services as per own need.
However, experience shows different challenges in order to provide sustainable harm reduction services to this often hard-to-reach population.
Mainline believes that quality harm reduction programmes should be efficiently targeted to the needs of the client and should be sustainable, consistent and widely available. This can only take place if services are embedded in a broader continuum of care for PWUD. However, organisations struggle to collect real-time data and assess the actual impact of their work. And with constant – political and financial – setbacks in our work, it is hard to set a quality standard.
Mainline believes that innovative solutions can overcome some of these challenges. Innovation and creativity within the harm reduction field are not only much needed, but it is the only way harm reduction can survive in the long run.
The Bridging the Gaps 2 programme fully embraces innovation and sees it as a means to sustainable solutions where current practices stop. The programme allows Mainline the unique opportunity to improve the quality of services, pilot new interventions and to learn.
By putting innovation high on our BtG2 agenda, Mainline hopes to benefit all of its partners within the programme and beyond in order to flag the importance of data collection, improve the quality standards of local programmes and increase access to harm reduction services for those who use drugs worldwide.
Mainline hopes to leave a positive mark in the harm reduction community and other key populations, such as sex workers and the LGBT-community.
The HIV-epidemic in Pakistan is centralised and concentrated. In Pakistan, HIV mainly affects people who inject drugs. In a country where drug use – although widespread – is a huge taboo and where sexuality is not always easily discussed – you can find one of the world’s most successful harm reduction programmes.
It is in Pakistan where Mainline supports and implements most of its innovative work. Read more about our current innovative pilots in Pakistan and find out how other key populations can also benefit from successful and/or failed pilots.
HIV incidence and associated risk factors in female spouses of men who inject drugs in Pakistan
Adherence to antiretroviral therapy among HIV positive men who inject drugs in Pakistan
Nepal
Mainline is asked to review the current harm reduction programmes in Nepal from the perspective of women who inject drugs. Based on interviews with women we hope to formulate recommendations to improve service delivery.
Netherlands, Belgium, Spain, Greece, Germany, France
Several risk factors increase the vulnerability of (new) groups of migrants to engage in problematic drug use. These risk factors include traumatic experiences, disengagement with society, unemployment and poverty. Services and municipalities throughout the European Union are faced with the urgent challenge to address these migrants’ needs.
Burkina Faso, Burundi, Egypt, Kenya, Marocco, Mozambique, Nigeria, South Africa, Uganda, Zimbabwe
Mainline is a partner in the Love Alliance programme. The Love Alliance brings together organisations led by communities most affected by HIV and AIDS.
Global
The use of drugs during sex is a growing worldwide phenomenon among men who have sex with men (MSM). Mainline has built a unique track record while working in the frontline of the Dutch 'chemsex' scene. Now, we also apply this expertise in an international context.
Brazil
Mainline is starting a two-year project in Recife, Brazil, together with LANPUD, and the Free School for Harm Reduction (ELRD). The project aims to expand harm reduction and HIV care and support for young people who use crack cocaine.
Vietnam
In 2021 and 2022, SCDI in Vietnam and Mainline can continue to strengthen and expand the available harm reduction offer for people who use meth-amphetamines. After establishing the regional field lab in 2019 and 2020 we now have the opportunity to push this innovative initiative to the next level. One important element: to improve and expand the community mental health response. Moreover, the skills that were built in Hanoi's field lab are ready to be further disseminated across the South East Asian Region.
Iran
Iran is renowned for its harm reduction programme. It was one of the first countries in this geographical region to adopt a harm reduction approach. Government supports and funds the programme. But the drug scene in Iran has changed over the past 20 years. More people are using stimulant drugs and, due to economic circumstances, more people who use drugs have become homeless. Mainline sets out to see whether the current programme in Tehran still fits the needs of the local people who use drugs.
Zimbabwe
Mainline have been asked to assess the drug scene in five provinces in Zimbabwe. A team of three researchers worked in close collaboration with the Zimbabwe Civil Liberties Drug Network throughout 2022. The goal: to gain an insight into which drugs are commonly used and to recommend health interventions.
United Kingdom, Finland, Greece, Estonia, Serbia, Portugal, the Netherlands
Harm reduction approaches are rarely applied in a recreational sports setting. And why would we - sport equals health, right? Not always. Research shows that the use of performance and image-enhancing drugs (PIEDs) is quite common in various recreational sport scenes. And for those people who use frequently and in high doses, harm reduction can make a big difference.
Zambia
Harm reduction is new in Zambia. Mainline was asked to estimate how many people inject drugs in the country and to map the already existing harm reduction and HIV services for people who use drugs. Based on this information, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.
South Africa
Women Who Use Drugs face additional problems compared to their male counterparts. The harm reduction field far too often neglects the needs of women. To some extent, the same is true for peer workers: incredibly valuable staff in any impactful service. How can local services make sure that peer workers are valued, supported and living up to their full potential? And how can access for women who use drugs be improved?
Kenya
Women who use drugs in Kenya face violence every day: At home. On the streets. By the police. In their communities. A unique study - conducted in Mombasa, Kenya - sheds light on the tough realities these women encounter. Urgent action is needed.
Kenya, South Africa
Young people use drugs - including minors. It's an inconvenient truth: societies usually seek to prevent young people from damaging their health and there is a big taboo on drug use among young kids. But are stigma, legislation or moral judgement keeping young people away from harm reduction services? This project aims to find and improve access to services.
Indonesia
Prisons in Indonesia are overcrowded and health services are limited. Is quality prison health too expensive? Not according to findings from Atma Jaya University, who applied the method of 'economic modelling' to prison health services, including drug dependency programmes. The findings fed important advocacy messages to improve the prison system in 2021. Moreover, Atma Jaya - via a 2021 implementation study - succesfully introduced motivational interviewing into the prison setting: an evidence-based method to assist people who are dependent on drugs and would like to reduce or quit their drug use.
South Africa
Together with activists and peer- and outreach workers in South Africa, Mainline worked on a practical guide about involving peers in harm reduction work.
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